The OpportunityWe are looking for a SIU Consultant (Triage). You will perform triage duties to review claims identified by our predicative fraud tool to determine if an SIU investigation is warranted Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures.
This role is remote eligible in the continental U.S. with occasional business travel. What you'll do:- Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims.
- Participates in the development of fraud prevention strategies.
- Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures.
- Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
- Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools.
- Make recommendations within defined authority guidelines.
- Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome.
- Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention.
- May serve as a resource team member on specific matters through demonstrated skill or training.
- Assists with the delivery of fraud awareness training initiatives in a defined environment.
- Handles CAT duty responsibilities as business requires.
- Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures
What you have:- High School Diploma or General Equivalency Diploma (GED).
- 2+ years' experience as an SIU Investigator investigating claims from multiple lines of business (auto/property)
- Fraud industry investigation experience.
- Experience obtaining statements from various parties to incidents, witnesses, and suspects.
- Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud.
- Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems.
- Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems.
- Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology.
What sets you apart:- Experience in analyzing digital fraud tool indicators to determine investigation necessity and triage cases
- 2+ years claims adjusting experience, OR 4+ years prior investigative law enforcement (to include military) or relevant
- US military experience gained through military service or gained as a military spouse / domestic partner
Compensation range: The salary range for this position is: $77,120 - $147,390
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.). Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
